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HIV in the Greater Washington Region

In recent years, Washington, D.C. has made tremendous progress in getting closer to the city’s goal of ending the local HIV epidemic. But new HIV cases continue to occur: 371 cases in 2015, and 13,391 D.C. residents are currently living with HIV.[1] Simply living in the District means that a person is more at risk for HIV. D.C. residents have a 1 in 13 chance of receiving an HIV diagnosis in their lifetime. [2] In contrast, for the average American, the chance is 1 in 99.[2]

Communities of color experience the highest rates of HIV infection in Washington, D.C. African Americans account for 75% of newly diagnosed HIV cases while only accounting for 47.4% of the D.C. population.[1] In fact, 4.6% of the District’s African American male population is living with HIV, followed by 2.1% of Latino/Hispanic men, and 1.9% of African American females.[1] According to the WHO, a generalized epidemic rate is 1%; communities of color in D.C. are all above that rate, signifying they are disproportionately impacted by HIV. In total, 11,274 individuals from communities of color are living with HIV, 84% of all living cases.[1] Wards 5, 6, 7, and 8, where the majority of African Americans live, had the highest rates of HIV and the highest poverty rates in the city.[3]

Racial/ethnic disparities also exist in terms of access to and engagement in care. Among those newly diagnosed with HIV in 2010-2014, 89% of white individuals were linked to care within three months of diagnosis (considered a best practice), compared to 78% of African Americans.[4] Africans Americans were less likely to have reached HIV viral suppression within 12 months of HIV diagnosis when compared to white individuals.[4] Overall, only 69% of D.C. residents living with HIV were engaged in continuous care in 2015, and only 57% had achieved HIV viral load suppression, making them less likely to transmit the disease.[4] HIV viral suppression is key to ending the epidemic as it greatly decreases the risk of HIV-positive individuals transmitting the disease to others. Viral suppression cannot be achieved without access to and engagement in care.

In addition to D.C., Northern Virginia and Suburban Maryland have been adversely affected by the HIV epidemic. In Northern Virginia, 6,686 individuals are living with HIV/AIDS, 28% of Virginia’s total.[5] Of Northern Virginians, 46% of those living with HIV were African American, and the primary mode of transmission was MSM (51%).[5] In Suburban Maryland, there were 10,629 individuals living with HIV, 36% of Maryland’s total.[6] Among living Suburban Maryland HIV cases, 77% were among Black populations, 64% were among men, and 49% were attributed to heterosexual contact, followed closely by MSM (42%).[7] Individuals seeking HIV-related services may travel across state lines, so it is important that efforts to eliminate HIV in D.C. are made available to residents of the entire region.